بررسي نقش هليكو باكتر پيلوري در رينوسينوزيت مزمن

The Role of H.Pylori in Chronic Rhino Sinusitis

ﺯﻣﻴﻨﻪ ﻭ ﻫـﺪﻑ: ﺭﻳﻔﻼﮐﺲ ﻻﺭﻧﮕـﻮﻓﺎﺭﻧﮋﻳﺎﻝ )LPR( ﻣﺤﺘـﻮﻳﺎﺕ ﻣﻌـﺪﻩ ﻣﻮﺟﺐ ﺍﻳﺠـﺎﺩ ﻋﻼﺋـﻢ ﻭ ﺑﻴﻤـﺎﺭﻱ ﻫﺎﻱ ﻣﺘﻔـﺎﻭﺗﻲ ﻣﻲ ﮔـﺮﺩﺩ ﮐـﻪ ﺍﺯ ﺁﻥ ﺟﻤـﻠﻪ ﺭﻳﻨﻮﺳﻴﻨـﻮﺯﻳﺖ ﻣـﺰﻣﻦ )CRS( ﺍﺳﺖ. ﺩﺭ ﺗﻌﻴﻴـﻦ ﭘﺎﺗﻮﻓﻴـﺰﻳﻮﻟﻮﮊﻱ ﺭﻳﻔﻼﮐﺲ ﻻﺭﻧﮕـﻮﻓﺎﺭﻧﮋﻳﺎﻝ ﺑﻪ ﻧﻘـﺶ ﻫﻠﻴﻜﻮ ﺑﺎﻛﺘﺮ ﭘﻴﻠﻮﺭﻱ ﺗﻮﺟـﻪ ﺷـﺪﻩ ﺍﺳﺖ ﻭﻟـﻲ ﺩﺭ ﻣـﻮﺭﺩ ﺁﻥ ﺍﺗﻔﺎﻕ ﻧﻈـﺮ ﻭﺟـﻮﺩ ﻧﺪﺍﺭﺩ. ﺑﻨﺎﺑﺮﺍﻳﻦ ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌـﻪ ﺑﻪ ﻧﻘـﺶ ﻫﻠﻴﻜﻮ ﺑﺎﻛﺘﺮ ﭘﻴﻠﻮﺭﻱ ﺩﺭ ﺭﻳﻨﻮﺳﻴﻨـﻮﺯﻳﺖ ﻣـﺰﻣﻦ ﻭ ﺍﺭﺗﺒـﺎﻁ ﺁﻥ ﺑﺎ ﺁﻟـﻮﺩﮔﻲ ﻫﻠﻴﻜﻮ ﺑﺎﻛﺘﺮ ﭘﻴﻠﻮﺭﻱ ﻣﻌـﺪﻩ ﭘﺮﺩﺍﺧﺘﻴﻢ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺍﻳـﻦ ﺗﺤﻘﻴـﻖ ﻳـﮏ ﻣﻄﺎﻟﻌـﺔ ﺑﺎﻟﻴﻨـﻲ ﮐـﻮﻫﻮﺭﺕ ﺍﺳـﺖ، ﮐـﻪ ﺩﺭ ﺁﻥ ﻳـﮏ ﮔـﺮﻭﻩ 18 ﻧﻔـﺮﻱ ﺍﺯ ﺑﻴﻤـﺎﺭﺍﻥ ﻣﺒﺘـﻼ ﺑـﻪ ﺭﻳﻨﻮﺳﻴﻨـﻮﺯﻳﺖ ﻣـﺰﻣﻦ ﺑﺎ ﮔـﺮﻭﻩ 18 ﻧﻔـﺮﻱ ﺍﻓـﺮﺍﺩ ﺷﺎﻫـﺪ ﺍﺯ ﻧﻈـﺮ ﻭﺟـﻮﺩ ﻫﻠﻴﻜﻮ ﺑﺎﻛﺘﺮ ﭘﻴﻠﻮﺭﻱ ﺩﺭ ﺳﻴﻨـﻮﺱ ﻭ ﻣﻌـﺪﻩ ﻣـﻮﺭﺩ ﻣﻘـﺎﻳﺴﻪ ﻗـﺮﺍﺭ ﮔـﺮﻓﺘﻨﺪ ﻭ ﺍﺯ ﺗﺴـﺖ(Polymerase Chain Reaction) PCR ﺑـﺎ ﺣﺴﺎﺳﻴﺖ ﻭ ﻭﻳـﮋﮔﻲ ﺑﺎﻻ ﺑـﺮﺍﻱ ﻳﺎﻓﺘـﻦDNA ﻫﻠﻴﻜﻮ ﺑﺎﻛﺘﺮ ﭘﻴﻠﻮﺭﻱ ﺍﺳﺘﻔـﺎﺩﻩ ﺷـﺪﻩ ﺍﺳـﺖ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﺩﺭ ﻧﻤـﻮﻧﻪ ﻫﺎﻱ ﺳﻴﻨـﻮﺱ ﻓﻘﻂ ﺩﺭ ﺩﻭ ﻣـﻮﺭﺩ ﺍﺯ ﮔﺮﻭﻩ ﺑﻴﻤﺎﺭ ﻫﻠﻴﻜﻮ ﺑﺎﻛﺘﺮ ﭘﻴﻠﻮﺭﻱ ﻣﺜﺒـﺖ ﺑﻮﺩ ﻛﻪ ﺍﻳﻦ ﻣﻴـﺰﺍﻥ ﺩﺭ ﮔـﺮﻭﻩ ﺷﺎﻫـﺪ 6 ﻣـﻮﺭﺩ ﺑﻮﺩ ﻛﻪ ﺍﻳﻦ ﺩﻭ ﺍﺭﺗﺒﺎﻁ ﻣﻌﻨﻲ ﺩﺍﺭﻱ ﺩﺭ ﺟﻬﺖ ﻣﻌﮑـﻮﺱ ﺑﺎ ﻫﻢ ﺩﺍﺷﺘﻨﺪ ﻭ ﺩﺭ ﻫـﺮ ﮔﺮﻭﻩ ﺑﻪ ﺗﻨﻬـﺎﻳﻲ ﺑﻴﻦ ﻣـﻮﺍﺭﺩ ﻣﺜﺒـﺖ ﻣﻌـﺪﻩ ﻭ ﺳﻴﻨـﻮﺱ ﺍﺭﺗﺒﺎﻃﻲ ﻭﺟﻮﺩ ﻧﺪﺍﺷﺖ )P<0.05(. ﻧﺘﻴﺠﻪ ﮔﻴـﺮﻱ: ﻫﻠﻴﻜﻮ ﺑﺎﻛﺘﺮ ﭘﻴﻠﻮﺭﻱ ﻧﻘﺸﻲ ﺩﺭ ﺭﻳﻨﻮﺳﻴﻨـﻮﺯﻳﺖ ﻣﺰﻣﻦ ﻧﺪﺍﺭﺩ ﻭ ﺳﻴﻨـﻮﺱ ﻓﻘـﻂ ﺑﻪ ﻋﻨـﻮﺍﻥ ﻣﺨـﺰﻥ، ﻣﻴـﺰﺑﺎﻥ ﻫﻠﻴﻜﻮ ﺑﺎﻛﺘﺮ ﭘﻴﻠﻮﺭﻱ ﺑﺪﻭﻥ ﺍﻳﺠﺎد ﺑﻴﻤﺎﺭﻱ ﺯﺍﻳﻲ ﺩﺭ ﺁﻥ ﺍﺳﺖ.

Introduction & Objective: Laryngopharyngeal Reflux (LPR) of gastric content, causes a spectrum of disease including Chronic Rhinosinusitis (CRS). Chronic infection due to H. Pylori is one of the suspected pathophysiology of CRS. Accordingly, this study was planned to determine the role of H. Pylori in CRS and LPR. Materials & Methods: This is a clinical cohort study. In this study a group of 18 patients with CRS is compared with a group of 18 controls with regards to H. Pylori role in CRS and LPR. PCR, a highly sensitive and specific diagnostic test is used to detect H.Pylori. Results: H. Pylori was positive only in 2 of 18 CRS patients. This number was 6 for control group. Unexpectedly, there was a reverse correlation between H. Pylori and CRS. Besides, there was no significant relation between positive cases of sinus and gastric samples in each group and between two groups. Conclusions: H. Pylori has no role in CRS and sinus is just a reservoir of H. Pylori without being afflicted.